关键词: 治疗 , 结肠穿孔, 诊断

Abstract:

 Objective To summarize the experience in diagnosis and treatment of peritoneal perforation of colon. Methods The clinical data of 26 patients with ruptured colon admitted to our hospital from January 2005 to October 2015 were analyzed retrospectively. Results Of 26 cases, colonic tumor perforation had nine cases, colon perforation after colonoscopy had 6 cases, traumatic perforation of colon had 2 cases, inflammatory bowel disease leads to perforation in 3 cases, fecal intestinal perforation spontaneous had 2 cases, colonic perforation had 2 cases, the perforated diverticulitis on colon was in 2 cases. Seventeen cases presented with acute peritonitis, 7 patients were mainly localized peritonitis, 2 cases mainly characterized by abdominal inflammatory mass. Medical history ：chronic constipation in 17 cases, the basic disease of Medicine such as Diabetes mellitus, atherosclerosis, cerebral infarction, coronary heart disease, chronic cough in 20 cases. Preoperative abdominal radiography showed 12 cases of subdiaphragmatic free air, four cases were confirmed by enema and ten cases were confirmed by surgery, including perforation of descending colon in 9 cases,  sigmoideum colon in 6 cases, transverse colon in 4 cases, ascending colon in 8, caecum in one. Eight cases were misdiagnosed before operation,  perforation of upper digestive tract in six cases, appendiceal perforation in two cases. All patients underwent surgical treatment, 21 cases were cured, 5 cases died. Conclusion Perforation of colon is sometimes difficult to diagnose before surgery. As long as suspicious and correct surgical indications, the patients should undergo early surgical treatment.

Key words: diagnosis, surgery, perforation of colon